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Exosomes and microvesicles (EMV) are associated with tumor spread and chemotherapy resistance, through expelling drugs outside the cancer cells (Liu and Wang 2023)

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Some ethnic groups were also pointed out as more likely to use, including non-Hispanic American Indian/Native Americans, multiracial, white or black adults

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The MR p leiotropy residual sum and outlier (MR PRESSO) global test, and multivariable extensions thereof 90 , were used to facilitate identification and removal of outlier instruments to correct potential directional horizontal pleiotropy and resolve detected heterogeneity